The Feasibility and Safety of Induction Chemotherapy Followed by Definitive Chemoradiation in Patients with Locally Advanced Cervical Cancer: A Single-Arm Phase II Clinical Trial

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 24; no. 4; pp. 1321 - 1330
• Main Authors: Ahmadloo, Niloofar, Heidarpourfard, Marzieh, Najib, Fatemeh Sadat, Shiravani, Zahra, Omidvari, Shapour, Mosalaei, Ahmad, Mohammadianpanah, Mohammad, Ansari, Mansour, Nasrollahi, Hamid, Khanjani, Nezhat, Kadkhodaei, Behnam, Hamedi, Sayed Hasan
• Format: Journal Article
• Language: English
• Published: Thailand West Asia Organization for Cancer Prevention 01.04.2023
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cisplatin; Combined Modality Therapy; Feasibility Studies; Female; Humans; Induction Chemotherapy; Middle Aged; Paclitaxel; Uterine Cervical Neoplasms - drug therapy; definitive chemoradiation; induction chemotherapy; locally advanced cervical cancer
• ISSN: 1513-7368; 2476-762X
• DOI: 10.31557/APJCP.2023.24.4.1321

The present study aimed at investigating the feasibility and safety of induction chemotherapy followed by definitive chemoradiation (dCRT) in patients with locally advanced cervical cancer. In this single-arm clinical trial, patients with cervical cancer (stages IB3-IVA) received a median four cycles of induction chemotherapy (paclitaxel and carboplatin, every three weeks) followed by dCRT (which consisted of the whole pelvis at the dose of 45-50 Gy along with weekly cisplatin (40 mg/m2) followed by intracavitary brachytherapy at the total dose of 80-90 Gy). Primary end point was local control at three months, which was assessed by gynecologic examination and pelvic MRI. The secondary outcome of the study was treatment-related toxicity. Seventy-four patients with the mean age of 51.6 ± 9.5 years were included. The most frequent (51.4%) disease stage was IIB. Complete and partial clinical responses were observed in 60.8% and 14.9% of patients, respectively. The frequency of progressive disease and stable disease were 14.9% and 9.5%, respectively. Grade II and III neutropenia (during neoadjuvant chemotherapy were 13.5% and 2.7%, respectively; these figures during chemoradiation were 29.7% and 13.5%, respectively. A treatment interruption was observed for 60.8% (45 cases) of patients during chemoradiation and 31.1% during  induction chemotherapy. Induction chemotherapy followed by chemoradiation is feasible in patients with locally advanced cervical cancer; however, the toxicity should be managed properly to avoid delayed e treatment. More than three quarters of the patients achieved complete or partial clinical response within a three-month follow-up.